Common types of congenital heart defects
Congenital heart defects are abnormalities that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only one defect or several that tend to occur in combination. Of the dozens of heart defects, some are mild and may need minimal or no medical treatment even through adulthood, while others are life-threatening, either immediately to the newborn or over time. Here's a look at some of the more common congenital heart defects. Compare them to the normal human heart, shown here.
Ventricular septal defect
Sometimes called a hole in the heart, this defect — the most common congenital heart defect — occurs when the septum, the muscular wall separating the right and left ventricles, fails to fully form. The hole allows oxygen-rich blood to leak from the left ventricle into the right ventricle, instead of moving into the aorta and on to the body. Too much blood may flood the lungs.
This defect can lead to heart failure, excessive blood pressure in the lungs (pulmonary hypertension), infections of the heart (endocarditis), irregular heartbeats (arrhythmias) and delayed growth. Small holes may heal on their own or cause no symptoms. Larger holes may require surgical repair by stitching together or covering with a patch.
Similar to a ventricular septal defect, this is a hole that occurs when the septum separating the right and left atria doesn't close properly. This allows blood from the left atrium to flow into the right atrium, instead of into the left ventricle and on to the aorta and the rest of the body.
The defect can cause several complications, including arrhythmias, heart failure, stroke and, in rare cases, pulmonary hypertension. Minor cases may cause no symptoms and may not require treatment. Larger defects may require surgical closure or cardiac catheterization.
Before birth, a temporary blood vessel called the ductus arteriosus connects the pulmonary artery and the aorta. This allows blood to bypass the lungs because oxygen is delivered to the fetus through the placenta and umbilical cord. The temporary vessel normally closes within a few hours or days of birth since the lungs take over. If it remains open (patent), some blood that should circulate through the body is misdirected to the lungs.
This defect can cause heart failure or endocarditis. In infants, it can be closed with medications. In older children and adults, plugs, coils or surgery can be used to close the vessel.
In this condition, the flow of blood from the right ventricle to the pulmonary artery is obstructed by narrowing at the pulmonary valve. When there's an obstruction (stenosis), the right ventricle must pump harder to get blood into the pulmonary artery. The defect may occur along with other defects, such as thickening of the muscle of the right ventricle immediately below the valve.
In many cases, pulmonary stenosis is mild and doesn't require treatment. But because it can cause heart failure, arrhythmias or enlargement of the right heart chambers, surgery may be necessary to repair the stenosis or replace the valve. Special balloons to widen the valve (balloon valvuloplasty) may also be used.
This is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump blood into the aorta. Mild cases may not have symptoms initially, but they can worsen over time.
The defect can cause heart enlargement, left-sided heart failure, arrhythmias, endocarditis and fainting. Treatment includes surgical repair or replacement of the valve or, in young children, widening through balloon valvuloplasty.
This is a narrowing (coarctation), or constriction, in a portion of the aorta. Coarctation forces the heart to pump harder to get blood through the aorta and on to the rest of the body.
This defect can cause several life-threatening complications, including severe hypertension, aortic aneurysm, dissection or rupture, endocarditis, brain hemorrhage, stroke, heart failure and premature coronary artery disease. Repair is typically recommended before age 10, either by surgically removing the affected portion or widening it through balloon angioplasty and placement of a stent.
With this defect, the positions of the aorta and the pulmonary artery (the great arteries) are reversed (transposed). The aorta arises from the right ventricle instead of the left and the pulmonary artery arises from the left ventricle instead of the right. This creates a circulatory pattern that prevents nourishing oxygenated blood from reaching the body.
This condition would quickly be fatal to a newborn except it's generally accompanied by another defect — commonly a septal defect or patent ductus arteriosus — that does allow oxygen-rich blood to get to the body. Surgical repair is usually necessary shortly after birth.
This defect is a combination of four (tetralogy) congenital abnormalities. The four defects typically are ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in an insufficient amount of oxygenated blood reaching the body.
Complications of tetralogy of Fallot (fuh-LOE) include cyanosis — sometimes called "blue baby syndrome," since the lips, fingers and toes may have a bluish tinge from lack of oxygen — as well as poor eating, inability to tolerate exercise, arrhythmias, delayed growth and development, and stroke. Surgical repair of the defects is required early in life.
